What is the purpose of sending a #1 rank LOI to a residency program?

[watermelon master]

Is sending a letter to a residency program saying that you're going to rank them #1 really helpful? Presumably the purpose of sending this letter is so that the program will move you up on the rank list, but what's to stop the PD from moving you DOWN on the list because they would rather have more competitive applicants and they will settle for you since they know you're putting them as #1? Does anybody have insight as to how often this might happen compared to the reverse where they end up ranking you higher? I wish post-interview communication wasn't allowed SMH

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[hallowmann]

Is sending a letter to a residency program saying that you're going to rank them #1 really helpful? Presumably the purpose of sending this letter is so that the program will move you up on the rank list, but what's to stop the PD from moving you DOWN on the list because they would rather have more competitive applicants and they will settle for you since they know you're putting them as #1? Does anybody have insight as to how often this might happen compared to the reverse where they end up ranking you higher? I wish post-interview communication wasn't allowed SMH

Is it helpful? Maybe... at some programs...
Will programs rank you lower? No. They will be ranking you how they want to rank you regardless. They will already have you below the "more competitive applicants" before you even send them any LOI.

I will say that we take interest in the program into account when considering ranking. That said, it doesn't significantly change anything. Generally, people are already in the order we want them. It more comes into play when we estimate who we're likely to match, which is more just an exercise in speculation.

 

[watermelon master]

Is it helpful? Maybe... at some programs...
Will programs rank you lower? No. They will be ranking you how they want to rank you regardless. They will already have you below the "more competitive applicants" before you even send them any LOI.

I will say that we take interest in the program into account when considering ranking. That said, it doesn't significantly change anything. Generally, people are already in the order we want them. It more comes into play when we estimate who we're likely to match, which is more just an exercise in speculation.

So if people are already ranked in the order that you want them - how would demonstrating interest in the program (rank #1 LOI) change anything? So it's just best to demonstrate this during the actual interview?

 

[NickNaylor]

So if people are already ranked in the order that you want them - how would demonstrating interest in the program (rank #1 LOI) change anything? So it's just best to demonstrate this during the actual interview?

At least in my program, these letters have absolutely zero impact on anything. Applicants often do this kind of thing because they are seeking, in vain, to obtain some kind of illusion of control and agency in this process and do things that have next to zero impact in the hopes that it will actually matter.

 

[sharkbyte]

^Pretty much what the above poster said. Post-interview communication is basically a game. Programs will send different variations of "ranked to match" emails to applicants and applicants will send different variations of "you're my #1" to programs. Both sides have been lied to and burned numerous times before (i.e. an applicant gets a really nice "we'd love to have you here" email from a program, reads too much into it, ranks that place #1 and doesn't match there, or a program ranks an applicant highly after that applicant tells them you're my #1, and that applicant matches elsewhere). Applicants and programs both want to (understandably) match high on their lists so that's why this stuff happens. It's all pretty stupid and I think post-interview communication should just be outright banned all over.

I think #1 emails from applicants might make a small difference at some programs but probably not at the majority of the programs. PDs have no obligation to believe applicants if they've been burned before. They're going to rank applicants the way they want. Although, I will say, there are probably ways to tell when someone is being genuine (i.e. it's a program in their hometown, they want to be really close to family/SO, they've indicated during interviews or letter of interest that the program is #1 for them) but even then, there's no way of being 100% certain.

 

[Chemist0157]

It is mostly a placebo effect to help applicants feel they have some control in a system that is much out of their control.

 

[Dr. Death]

Some programs have explicitly told us applicants "if you want to be here, let us know." Reading between the lines, it seems like programs want to rank applicants who would be happy to match at their program, and it may affect the rank list

 

[hallowmann]

So if people are already ranked in the order that you want them - how would demonstrating interest in the program (rank #1 LOI) change anything? So it's just best to demonstrate this during the actual interview?

In my program, at best it moves you up 1 rank, but like you said it's more about everyone's interaction with you at the interview. It gets brought up as a positive, but in all honesty the impact on the actual ROL is minimal compared to a lot of other factors.